Annals for Hospitalists Inpatient Notes - Fluid Resuscitation for Noncritically Ill Patients With Acute Pancreatitis
Authors: Lucía Guilabert, Enrique de-Madaria
Journal: Annals of Internal Medicine (2023)

Web ExclusivesMay 2023Annals for Hospitalists Inpatient Notes - Fluid Resuscitation for Noncritically Ill Patients With Acute PancreatitisLucía Guilabert, MD, and Enrique de-Madaria, MD, PhDLucía Guilabert, MDDepartment of Gastroenterology, Dr. Balmis General University Hospital-ISABIAL, Alicante, Spain (L.G.)Search for more papers by this author, and Enrique de-Madaria, MD, PhDDepartment of Gastroenterology, Dr. Balmis General University Hospital-ISABIAL, Alicante; Department of Clinical Medicine, Faculty of Medicine, Miguel Hernández University, Elche, Spain (E.de-M.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0792 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Acute pancreatitis (AP) is the third most common gastrointestinal cause of hospital admission (1). Fluid resuscitation has traditionally been considered the most important early intervention in AP. However, what does the evidence show to be the optimal fluid management strategy in AP?Until recently, aggressive fluid resuscitation was encouraged in AP. The evidence supporting it came from indirect data, mainly from observational, single-center studies (2). Previous randomized controlled trials (RCTs) have been single center, with very specific patient populations, and have provided contradictory findings (3). The WATERFALL (Aggressive Versus Non-aggressive Goal-directed Fluid Resuscitation in Acute Pancreatitis) trial was the first ...References1. Peery AF, Crockett SD, Murphy CC, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2021. Gastroenterology. 2022;162:621-644. [PMID: 34678215] doi:10.1053/j.gastro.2021.10.017 CrossrefMedlineGoogle Scholar2. de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or moderate fluid resuscitation in acute pancreatitis. N Engl J Med. 2022;387:989-1000. [PMID: 36103415] doi:10.1056/NEJMoa2202884 CrossrefMedlineGoogle Scholar3. García-Rayado G, Cárdenas-Jaén K, de-Madaria E. Towards evidence-based and personalised care of acute pancreatitis. United European Gastroenterol J. 2020;8:403-409. [PMID: 32213025] doi:10.1177/2050640620903225 CrossrefMedlineGoogle Scholar4. de-Madaria E, Banks PA, Moya-Hoyo N, et al. Early factors associated with fluid sequestration and outcomes of patients with acute pancreatitis. Clin Gastroenterol Hepatol. 2014;12:997-1002. [PMID: 24183957] doi:10.1016/j.cgh.2013.10.017 CrossrefMedlineGoogle Scholar5. Zhou S, Buitrago C, Foong A, et al. Comprehensive meta-analysis of randomized controlled trials of lactated Ringer's versus normal saline for acute pancreatitis. Pancreatology. 2021;21:1405-1410. [PMID: 34332907] doi:10.1016/j.pan.2021.07.003 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Lucía Guilabert, MD; Enrique de-Madaria, MD, PhDAffiliations: Department of Gastroenterology, Dr. Balmis General University Hospital-ISABIAL, Alicante, Spain (L.G.)Department of Gastroenterology, Dr. Balmis General University Hospital-ISABIAL, Alicante; Department of Clinical Medicine, Faculty of Medicine, Miguel Hernández University, Elche, Spain (E.de-M.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0792.Corresponding Author: Enrique de-Madaria, MD, PhD, Servicio de Aparato Digestivo, Hospital General Universitario Dr. Balmis, C. Pintor Baeza 12, Alicante, 03010, Spain; e-mail, [email protected]es. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - May 2023 David H. Wesorick Metrics Current IssueMay 2023Volume 176, Issue 5KeywordsAcute pancreatitisFluid managementPancreasSaline solutions ePublished: 16 May 2023 Issue Published: May 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...